Vol 8, No 3 (2001)


On the state of orthopedic and trauma care for the children's population of the Russian Federation and the prospects for its development (based on the report at the scientific and practical conference "Current Issues of Pediatric Traumatology and Orthopedics")

Malakhov O.A.


The life and health of children is the health of the future of Russia, and therefore the protection of motherhood and childhood, the formation of state policy in this area are a priority area, the cornerstone of the strategic development of health care.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):3-7
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Basic principles of examination and treatment of patients with post-traumatic heterotopic ossifications in the elbow joint

Ovsyankin N.A., Nikityuk I.E.


Results of complex examination and treatment of 103 patients, aged 4-14, with posttraumatic heterotopic ossificates in the elbow zone are presented. Clinical, radiologic, electrophysiologic, radioisotopic, biomechanical, termovision and morphologic methods were used. Depending on the extent of the pathological process the ossificates resection was performed with either simple or expanded arthrolysis of the elbow joint. Expanded arthrolysis included the formation of fossae and through canal in the distal humerus, open reduction or resection of the radius head. Long term follow up showed good and satisfactory functional and anatomical results in 89.3% and 85.7% of cases, respectively. The mean range of motion in elbow joints increased by 57°. Recurrent ossificates were observed only in 4.6%) of patients.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):8-12
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Methods of clinical assessment of the functional state of the hip joint in children and adolescents

Tsykunov M.B., Eremushkin M.A., Sharpar V.D.


Original method for clinical evaluation of the hip functional state in children and adolescents is presented. This method includes passport data, case history, subjective signs, special functional test and motor tasks, clinical and instrumental examination. Every sign is assessed in points: 5 points — absence of pathological changes and this corresponds to function compensation; 3—4 points — moderately marked changes — subcompensation; less than 3 points — marked changes — decom­pensation. Final evaluation of the hip functional state is the integral index. 107 joints in 83 patients with various hip dysplasias were examined. All patients were on target rehabilitation treatment that resulted in the improvement of the functional state. The repeated postrehabilitation testing showed increase in integral index within 1—2 points. In 30 patients the compensation of function was achieved, 34 patients subcompensation was observed. Decompensation persisted in 19 patients.


N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):13-18
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Autoplasty of post-resection defects of long bones in modern treatment of osteogenic sarcoma in children

Kovalev V.I., Starostina A.Y., Strykov V.A., Kovalev D.V., Bystrov A.V., Borodachev A.V., Loseva M.S.


High survival rate obtained in the treatment of osteogenic sarcoma resulted in substitution of organ-removing operations to organ-saving ones. Methods of total joint replacement used in adult practice can not be so widely applied in paediatric practice due to incompleteness of skeleton growth in children. The solution of the problem is the methods of autoplasty using the fibula including free transplantation, transposition of fibula with nutritional tissue mass and plasty by vascularized graft. Fibula autoplasty is efficient in application with the complex of antineoplastic chemotherapy and postoperative management of patients as well as the treatment of possible complications. This is confirmed by the data of examination of 91 patients with osteogenic sarcoma, aged 4—15, who were treated at Oncology Department of the Russian Paediatric Clinical Hospital in the period from 1987 to 1998.


N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):18-24
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To the question of the treatment of malformation of the leg bones in combination with popliteal pterygium

Karimov L.F., Pozdeev A.P., Buklaev D.S.


The technique for the treatment of crus malformation accompanied by popliteal pterygium is suggested. The method consists of three stages. First stage is the lengthening of m. gastrocnemius and dissection of tape and cord-like bands. In the second stage hinge distraction device is applied and asymmetric distraction is performed, then pterygium popliteal fold is distended and incorrect position of the limb is eliminated. During the third stage the additional foot is resected and ligaments of knee joint are created from the muscular tendon of the additional foot.


N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):24-25
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A method for arthroscopic fixation of the cruciate ligaments of the knee joint in case of their acute injury

Mironov S.P., Orletsky A.K., Vetrila V.S.


In acute cruciate ligament injuries the technique of arthroscopic fixation of the ligaments is suggested. The technique consists of the sewing of the injured cruciate ligament to the uninjuired one. The indication to operative treatment is the full or partial tears of ACL or PCL from the femoral attachment site. In experimental cadaveric knee study the stabilizing effect of this operative technique is proven. Three patients were operated on and good results were achieved.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):26-28
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Treatment of uncomplicated rotator cuff injuries

Makarevich E.R.


The work was grounded on the analysis of the examination data and treatment results of 130 patients with uncomplicated rotator cuff injuries. Clinical manifestation and radiographic find­ings were described for the different types of injuries. Differentiated methods for the treatment were suggested. Forty two patients with partial local cuff injuries were on conservative treatment. In 38 patients that treatment was successful and in 4 patients with degenerative cuff changes the treatment was failed. Ninety two patients were operated on. Good and excellent results were achieved in 90.2%) of cases, satisfactory and poor — in 9.8%. Poor outcomes (4 patients) were resulted from formation of acromion pseudoarthrosis and development of wound infection, satis­factory outcomes (5) were resulted from cuff suture failure and scar development in defect plasty.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):29-33
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The use of osteogenon in the complex treatment of patients with skeletal fractures

Izmalkov S.I., Caskets Y.V.


In patients with acute locomotor system injuries the efficacy of osteogenon for the optimization of reparative processes was studied. Osteogenon was taken by 48 out-and inpatients with bone fractures of different localization. Control group uncluded the patients with similar fractures without osteogenon administration. Comparison of data obtained with the systemic multifactor analysis showed more quick relief of pain and more expressed callus formation in patients who received osteogenon. No complications were detected.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):33-36
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The effect of low-intensity laser radiation on the healing of microbial-contaminated soft tissue and bone wounds in an open fracture (experimental study)

Azizov M.J., Khanaiiyaev W.H., Baibekov I.M.


Influence of low intensive laser irradiation (LILI) on the healing of the infected osseous and soft tissue wound in experimental open fracture was studied using transmission and electron micros­copy. LILI provided antimicrobic affect on the infected wounds increasing phagocytosis by neutrophiles and accelerating the formation of callus.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):36-39
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Lower limb lengthening after replantation

Oganesyan O.V., Stepanov G.A.


Two cases of lower limb lengthening after replantation are presented. Both patients had detach­ment of lower limb at the level of low third of the crus. The patients were admitted to the hospital 17 and 12 hours after injury. Detached limb segments were transported in two polyethylene bags with ice. At replantation arteria tibialis posterior and accompanying veins were anastomosed. One and 1.5 years after replantation the cruses were lengthened using the external fixation device. The lengthening of the crus was equal to 13 and 11 cm, respectively.


N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):39-41
pages 39-41 views

Osteotomy "scarf" in the treatment of patients with valgus deformity of the first toe

Divakov M.G., Osochuk V.S.


The use of «scarf» osteotomy in 9 patients (14 feet) with valgus deformity of great toe was analysed. That technique was showed to provide stable correction of varus deviation of the first metatarsal bone and valgus deformity of the great toe as well as correction of the length of the first metatarsal bone and elimination of its pronator rotation without development of avascular necrosis of the head in postoperative period. Rigid fixation of bone fragments provides the possibility of early activization and rehabilitation of patients.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):41-45
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Comparative Evaluation of the Efficiency of Fixation of Fragments of the Navicular Bone of the Wrist with Screws of Different Designs

Anisimov V.N., Leontiev N.V., Stroganov A.B.


Experimental clinical study of peculiarities of navicular bone fractures and comparative estima­tion offixation efficacy using screws of different shape were performed. Compressive properties of the authors’ screws were 1.4 times and 2.5 times higher in comparison with conic and cylindrical screws, respectively. In the treatment of navicular bone fractures clinical experience was studied using the method of screw compression osteosynthesis. The advisability of application of the authors’ screw was substantiated by the treatment results. In 92.7% of patients with ununited navicular bone fractures and in all cases with acute fractures complete healing was detected.


N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):45-47
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Dispensary control of patients with deforming gonarthrosis

Dubrovin G.M., Kovalev P.V., Storozhenko N.V., Tikhonenkov S.N.


The monitoring system for the course of deforming gonarthrosis based on the basis of quantitative estimation of the main disease signs is suggested. Significance of a sign is evaluated in scores according to the used clinical classification of deforming osteoarthrosis. There were 23 patients with deforming gonarthrosis. Graphic imaging of course severity of the disease as well as efficacy of the treatment is suggested. Revealing of the characteristic types of disease course allows to control and correct management as well as to detect the indications to operative treatment.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):48-53
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Comparative study of the apparatus of the cruciate ligaments of the knee joint. I. Tetrapods with lateral limbs

Nikitin V.B., Mironov S.P., Lisitsyn M.P., Makarov A.N., Gulimova V.I., Saveliev S.V.


The principal function of the menisci is probably connected with the sliding movements during the rotation of the tibia along the long axis. In tetrapods the central position of the cruciate ligament apparatus should be probably primitive while the medial position of this apparatus is derived. In the line of frog-turtle-lizard-human the histological structure of the cruciate ligament shows a tendency to increase the mechanical durability based on the organization of fibers. Tetrapods with lateral limbs have no neural tissue within the cruciate ligaments unlike the human ones.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):53-59
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About segmental resection of the limb and its variant - operations borggeve—van ness

Makhson A.N.


The founders of the method of segmental resection of the limb as an alternative to its amputation are Russian surgeons P.I. Tikhov and N.A. Bogoraz. At the beginning of the 20th century, they put forward the idea - to preserve the unaffected peripheral (functionally most valuable) section of the limb on the main vessels and main nerve trunks in case of tumors of the bones of the limbs, resecting its central section (segment).

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):59-61
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Anesthesia and maintenance of homeostasis in the surgical treatment of children with systemic diseases of the skeleton

Frantov R.B.


Anesthesiological and resuscitation support during surgical interventions in children with systemic skeletal diseases (SDS) presents certain difficulties. This is due to the functional changes in such patients and the insufficiency of various organs and systems, as well as the disproportionate development of the facial part of the skeleton and deformation of the chest, which makes it difficult to intubate the trachea, impaired airway patency with possible subsequent development of respiratory insufficiency. Often used during operations on the extremities, the application of a tourniquet leads to the development of severe tachycardia, hypertension, aggravation of metabolic acidosis and intoxication, which are extremely difficult to stop, especially in this group of children with pneumosclerosis and cardiopathy.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):61-64
pages 61-64 views


Analytical review of dissertations reviewed and approved by the vacancy of Russia in 2000, specialty 14.00.22 - traumatology and orthopedics

Kotelnikov G.P.


In 2000, the Higher Attestation Commission of Russia in the specialty 14.00.22 (traumatology and orthopedics) reviewed and approved 122 dissertations, including 30 (24.6%) doctoral (in 1999 - 19, or 18.6% ) and 92 (75.4%) candidates (in 1999 - 83, or 81.4%). There were no dissertations rejected. There were no violations of the “Regulations of the Higher Attestation Commission of the Russian Federation” during the defense of dissertations.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):64-69
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Proprioceptive function of the cruciate complex of the knee joint (literature review)

Andreeva T.M., Lisitsyn M.P.


The question of the role of proprioceptive sensitivity in ensuring the normal kinematics of the joints, including the knee, has increasingly attracted the attention of researchers in recent decades. The position on the significance of intra-articular receptors and the concept of proprioception are not new [2, 3]. At the end of the 19th century, Duchenne was one of the first to point out the clinical significance of articular sensitivity. The term "proprioception" was introduced by Sherrington in 1906 [57]. Abbott et al. [4] and Gardner [27] found that the ligaments of the knee joint have a rich sensory innervation that acts as the first link in the kinematic chain. Abbott noted that the impulses that arise in the ligaments are transmitted through the central nervous system to the muscles and this allows you to establish normal, uniform, coordinated movements. Pathologically strong impulses arising from excessive stretching of the ligaments cause contraction of the conjugate muscle group, thereby preventing damage to the soft tissue component of the knee joint.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):69-74
pages 69-74 views


Aidyn Salarovich Imamaliev


In July 2001, Doctor of Medical Sciences, Professor of the Department of Traumatology, Orthopedics and Military Field Surgery of the Moscow State Medical and Dental University, Honored Scientist of the Russian Federation, Honored Inventor of the Russian Federation Aidyn Saparovich Imamaliev turned 75 years old.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):76-77
pages 76-77 views

Stepan Timofeevich Vetrila


June 27, 2001 marks the 60th anniversary of the head of the Department of Spine Pathology of the Central Institute of Traumatology and Orthopedics. N.N. Priorov to Professor S.T. Sails.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):77-77
pages 77-77 views

Oleg Alekseevich Malakhov


July 13, 2001 was the 60th anniversary of the head of the clinic for pediatric orthopedics of the Central Institute of Traumatology and Orthopedics. N.N. Priorov to the Honored Doctor of the Russian Federation, Doctor of Medical Sciences, Professor, Academician of the Academy of Medical and Technical Sciences, Chief Orthopedist of the Moscow Health Committee, Chief Children's Orthopedic Traumatologist M3 of the Russian Federation O.A. Malakhov.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):78-79
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Mikhail Nikolaevich Nikitin


On January 31, 2001, Doctor of Medical Sciences, Professor M.N. Nikitin. The life of a remarkable scientist, teacher and surgeon was cut short.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):79-79
pages 79-79 views

Vladimir Vasilievich Kuzmenko


Domestic traumatology and orthopelia, editorial board of the journal “Bulletin of traumatology and orthopedics named after A.I. N.N. Priorov" suffered a heavy loss: on June 18, 2001, at the age of 65, an outstanding orthopedic traumatologist, Honored Scientist of the Russian Federation, Head of the Department of Traumatology, Orthopedics and Military Field Surgery of the Russian State Medical University, Doctor of Medical Sciences Professor Vladimir Vasilievich died suddenly Kuzmenko.

N.N. Priorov Journal of Traumatology and Orthopedics. 2001;8(3):81-81
pages 81-81 views

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